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Anal Pathologies: What Management at the Reference Health Center of Bamako’s Commune V?

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Open Journal of gastroenterology 2024年第3期14卷 87-92页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Ousmane Diarra Abou A. Diarra Drissa Katilé Abdoulaye Maiga Ouatou Mallé Sabine Drabo Makan S. Tounkara Hourouma Sow Kadiatou Doumbia Anselme Konaté Moussa T. Diarra hepato-gastroenterology Department CHU Point G Bamako Mali Service d’hépato-gastroentérologie CHU Gabriel Touré Bamako Mali hepato-gastroenterology unit CSREF Commune V Bamako Mali

Anal pathologies are conditions affecting the anal margin and the anal canal. The aim of our study was to update data on anal diseases. Non-specific, it can reveal an emergency, a serious illness, a chronic disease or a benign condition. It was a prospective, descriptive and analytical study from April 2022 to March 2023, carried out in the hepato-gastroenterology unit of the Centre de Santé de Référence de la commune V du District de Bamako in Mali. Out of seven hundred and forty-nine (749) patients seen in consultation, 98 had anal pathology, i.e. a prevalence of 13.08%. The mean age was 40 ± 15.15 years and the sex ratio was 1.5. Hemorrhoidal disease and anal fissure were the most frequent pathologies in 66.4% and 24.4% of cases respectively. Medical treatment was initiated in 91.9% of patients with hemorrhoidal disease and 91.7% with anal fissure. Anal pathologies are common in young male patients. In our context, they are dominated by benign conditions.

关键词： Anal Pathologies Hemorrhoidal Disease Anal Fissure

Utility of plasma D-dimer for diagnosis of venous thromboembolism after hepatectomy

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World Journal of Clinical Cases 2024年第2期12卷 276-284页

作者： Taiichiro Miyake Hiroaki Yanagimoto Daisuke Tsugawa Masayuki Akita Riki Asakura Keisuke Arai Toshihiko Yoshida Shinichi So Jun Ishida Takeshi Urade Yoshihide Nanno Kenji Fukushima Hidetoshi Gon Shohei Komatsu Sadaki Asari Hirochika Toyama Masahiro Kido Tetsuo Ajiki Takumi Fukumoto Division of hepato-Biliary-Pancreatic Surgery Department of SurgeryKobe University Graduate School of MedicineKobe 650-0017HyogoJapan

BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of *** use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative ***,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after *** To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after *** The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively *** were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower *** factors,including demographic data and perioperative D-dimer values,were compared between the two *** operating characteristic curve analysis was performed to determine the D-dimer cutoff *** and multivariate analyses were performed using logistic regression analysis to identify significant *** In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE *** the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after *** Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the

关键词： Hepatectomy Malignant tumor Postoperative complication D-dimer Early diagnosis Venous thromboembolism

Relationship between portal hypertension and liver stiffness measurements in the treatment of hepatocellular carcinoma from the surgeon’s point of view in the Baveno VII era

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hepatobiliary Surgery and Nutrition 2024年第1期13卷 150-153页

作者： Nobuyuki Takemura Norihiro Kokudo hepato-Biliary Pancreatic Surgery Division Department of SurgeryNational Center for Global Health and MedicineShinjyuku-kuTokyoJapan

hepatocellular carcinoma(HCC)is the third leading cause of cancer-related deaths worldwide(1).It often arises from the backgrounds of damaged liver due to viral hepatitis,alcoholic,or non-alcoholic liver *** the proportion of patients with HCC of non-hepatitis B and C origins has increased in recent years,hepatitis B and C viruses still cause more than half of all carcinogenesis in patients with HCC(2).Patients with HCC often develop portal hypertension(PHT)from cirrhosis due to the deterioration of the background liver,which proves to be the greatest obstacle to various types of treatments for HCC.

关键词： hepatocellular carcinoma(HCC) portal hypertension(PHT) Baveno VII hepatectomy clinically significant portal hypertension(CSPH)

Impact of neoadjuvant multimodal therapy in the setting of locally advanced hepatocellular carcinoma

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World Journal of gastroenterology 2024年第28期30卷 3452-3455页

作者： Daniele Ferraro Federica Falaschi Luca Nazzaro Giovanni Vennarecci hepato-biliary and Liver Transplant Centre Department of General Surgery and Woman’s HealthAORN Antonio CardarelliNaples 80131Italy

Immunotherapy and the implementation of more aggressive treatment schemes for locally advanced hepatocellular carcinomas have expanded the boundaries of curative *** of these advancements,patients who were once consid... 详细信息

关键词： hepatocellular carcinoma Immunotherapy Radioembolization Chemoembolization Liver transplantation Liver resection

Gaucher disease:New developments in treatment and etiology

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World Journal of gastroenterology 2008年第25期14卷 3968-3973页

作者： Ozgur Harmanci Yusuf Bayraktar Department of gastro-enterology Hacettepe University Faculty of Medicine

Gaucher disease (GD) is an autosomal recessive disease which if undiagnosed or diagnosed late results in devastating complications. Because of the heterozygous nature of GD, there is a wide spectrum of clinical presentation. Clinicians should be aware of this rare but potentially treatable disease in patients who present with unexplained organomegaly, anemia, massive splenomegaly, ascites and even cirrhosis of unknown origin. The treatment options for adult type GD include enzyme replacement treatment (ERT) and substrate reduction treatment (SRT) depending on the status of the patient. Future treatment options are gene therapy and "smart molecules" which provide specifi c cure and additional treatment options. In this review, we present the key issues about GD and new developments that gastroenterologists should be aware of.

关键词： Gaucher disease Enzyme replacementtreatment Substrate reduction treatment Genetherapy Liver fibrosis

Selective internal radiation therapy segmentectomy:A new minimally invasive curative option for primary liver malignancies?

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World Journal of gastroenterology 2024年第18期30卷 2379-2386页

作者： Riccardo Inchingolo Francesco Cortese Antonio Rosario Pisani Fabrizio Acquafredda Roberto Calbi Riccardo Memeo Fotis Anagnostopoulos Stavros Spiliopoulos unit of Interventional Radiology “F.Miulli”Regional General HospitalBari 70021Italy Interdisciplinary Department of Medicine Section of Nuclear MedicineUniversity of Bari“Aldo Moro”Bari 70121Italy Department of Radiology General Regional Hospital“F.Miulli”Acquaviva delle Fonti 70021Italy unit of hepato-Pancreatic-Biliary Surgery “F.Miulli”Regional General HospitalBari 70021Italy The Second Radiology Department National and Kapodistrian University of AthensChaidari Athens 12461Greece

Transarterial radioembolization or selective internal radiation therapy(SIRT)has emerged as a minimally invasive approach for the treatment of *** percutaneous technique involves the local,intra-arterial delivery of radioactive microspheres directly into the *** employed as a palliative measure for liver malignancies,SIRT has gained traction over the past decade as a potential curative option,mirroring the increasing role of radiation *** latest update of the BCLC hepatocellular carcinoma guidelines recognizes SIRT as an effective treatment modality comparable to other local ablative methods,particularly well-suited for patients where surgical resection or ablation is not *** segmentectomy is a more selective approach,aiming to deliver high-dose radiation to one to three specific hepatic segments,while minimizing damage to surrounding healthy *** research efforts in radiation segmentectomy should prioritize optimizing radiation dosimetry and refining the technique for super-selective administration of radiospheres within the designated hepatic segments.

关键词： Transarterial radioembolization Selective internal radiation therapy Radiation segmentectomy hepatocellular carcinoma Primary liver malignancies Personalised dosimetry

Cholangiocarcinoma:A compact review of the literature

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World Journal of gastroenterology 2008年第42期14卷 6458-6466页

作者： Yucel Ustundag Yusuf Bayraktar Department of Internal Medicine Gastro-enterology Clinic School of Medicine Karaelmas University Department of Internal Medicine Gastro-enterology Clinic School of Medicine Hacettepe University

Cholangiocarcinoma(CC) is a devastating cancer aris-ing from biliary ***,the incidence of this disease is increasing in Western *** tumors progress insidiously,and liver failure,biliary sepsis,malnutrition and cancer cachexia are general modes of death associated with this *** date,no established therapy for advanced dis-ease has been established or ***,our knowledge in tumor biology is increasing dramatically and new drugs are under investigation for treatment of this notorious *** clinical practice,there are better diagnostic tools in use to facilitate an earlier diagnosis of CC,at least in those patients with known risk *** is resectable for cure in only a small percentage of *** staging for vas-cular and biliary extension of CC is very important in this *** and recently endosonography seem to protect against unnecessary laparotomies in these *** the last 15 years,aggressive surgical approaches,including combined liver resec-tions and vascular reconstructive surgical expertise,have improved survival in patients with *** is contraindicated in CC cases having primary sclerosing cholangitis(PSC).Although CC was previously consid-ered a contraindication to liver transplantation,new cautious protocols,including neo-adjuvant chemora-diation therapies and staging procedures before the transplantation,have made it possible to achieve long-term survival after liver transplantation in this *** ablative therapies with photodynamic therapy,intraductal high-intensity ultrasonography and chemo-therapy-impregnated plastic biliary endoprosthesis are important steps in the palliative management of extra-hepatic *** and chemo-embolization methods are also applicable for intra-hepatic CCs as palliative modes of *** need more prospec-tive randomized controlled trials to evaluate the role of the new emerging therapies for CC patients.

关键词： Cholangiocarcinoma Primary sclerosing cholangitis Radiofrequency ablation Chemoembolization

Endoscopic management of pancreatic fluid collectionsrevisited

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World Journal of gastroenterology 2017年第15期23卷 2660-2672页

作者： Zaheer Nabi Jahangeer Basha D Nageshwar Reddy Department of gastroenterology Asian Institute of Gastro-enterology

The development of pancreatic fluid collections(PFC) is one of the most common complications of acute severe pancreatitis. Most of the acute pancreatic fluid collections resolve and do not require endoscopic drainage. However, a substantial proportion of acute necrotic collections get walled off and may require drainage. Endoscopic drainage of PFC is now the preferred mode of drainage due to reduced morbidity and mortality as compared to surgical or percutaneous drainage. With the introduction of new metal stents, the efficiency of endoscopic drainage has improved and the task of direct endoscopic necrosectomy has be-come easier. The requirement of re-intervention is less with new metal stents as compared to plastic stents. However, endoscopic drainage is not free of adverse events. Severe complications including bleeding, perforation, sepsis and embolism have been described with endoscopic approach to PFC. Therefore, the endoscopic management of PFC is a multidisciplinary affair and involves interventional radiologists as well as GI surgeons to deal with unplanned adverse events and failures. In this review we discuss the recent advances and controversies in the endoscopic management of PFC.

关键词： Endotherapy Pseudocyst Pancreatic necrosis Necrosectomy

Systematic review: Safety of balloon assisted enteroscopy in Crohn's disease

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World Journal of gastroenterology 2016年第40期22卷 8999-9011页

作者： Ahilan Arulanandan Parambir S Dulai Siddharth Singh William J Sandborn Denise Kalmaz Division of gastro-enterology University of California San Diego

AIM To determine the overall and comparative risk of procedure related perforation of balloon assisted enteroscopy(BAE) in Crohn's disease(CD). METHODS Systematic review(PROSPERO #CRD42015016381) of studies reporting on CD patients undergoing BAE. Seventy-three studies reporting on 1812 patients undergoing 2340 BAEs were included. Primary outcome of interest was the overall and comparative risk of procedure related perforation of diagnostic BAE in CD. Secondary outcomes of interest were risk of procedure related perforation of diagnostic double balloon enteroscopy(DBE), risk of procedure related perforation of therapeutic BAE, efficacy of stricture dilation, and clinical utility of endoscopically assessing small bowel disease *** Per procedure perforation rate of diagnostic BAE in CD was 0.15%(95%CI: 0.05-0.45), which was similar to diagnostic BAE for all indications(0.11%; IRR = 1.41, 95%CI: 0.28-4.50). Per procedure perforation rate of diagnostic DBE in CD was 0.12%(95%CI: 0.03-0.44), which was similar to diagnostic DBE for all indications(0.22%; IRR = 0.54, 95%CI: 0.06-0.24). Per procedure perforation rate of therapeutic BAE in CD was 1.74%(95%CI: 0.85-3.55). Eighty-six percentof therapeutic perforations were secondary to stricture dilation. Dilation was attempted in 207 patients and 30% required surgery during median follow-up of 18 months. When diagnostic BAE assessed small bowel disease activity, changes in medical therapy resulted in endoscopic improvement in 77% of patients. CONCLUSION Diagnostic BAE in CD has a similar rate of perforation as diagnostic BAE for all indications and can be safely performed in assessment of mucosal healing.

关键词： Crohn’s disease Balloon Enteroscopy Safety Perforation Stricture